Gaming with Mr. Slot or gaming the slot machine? Power, anthropomorphism, and risk perception

We propose that risk perceptions are systematically influenced by anthropomorphism. Anthropomorphism effects, however, are moderated by the individual's feelings of social power. People with low power perceive higher risk in playing a slot machine (study 1) and in getting skin cancer (study 2) when the risk-bearing entities (the slot machine and skin cancer) are highly anthropomorphized. In contrast, those with high power perceive greater risk when the entities are less anthropomorphized. We hypothesize these effects occur because those with high (low) power perceived a greater (lesser) degree of control over the anthropomorphized entity. In study 3, we investigate the reverse effect that higher perceived risk may increase anthropomorphism for people with low power but decrease anthropomorphism for people with high power. © 2010 by JOURNAL OF CONSUMER RESEARCH, Inc.published_or_final_versio

Less About Me, More About You: How Self-Affirmation Changes Word-Of-Mouth Intentions For the Self Versus Others

Four studies found that self-affirmation influenced word-of-mouth (WOM), decreasing consumers’ complaints about their own negative experiences but increasing complaints on behalf of others. We further found that affirmation induced broader perspectives, which muted the intensity of the self’s experiences while intensifying an appreciation of others’ emotions.published_or_final_versio

Rationale and design of a randomised phase III registration trial investigating finerenone in participants with type 1 diabetes and chronic kidney disease: The FINE-ONE trial

AIMS: Despite guideline-recommended treatments, including renin angiotensin system inhibition, up to 40 % of individuals with type 1 diabetes develop chronic kidney disease (CKD) putting them at risk of kidney failure. Finerenone is approved to reduce the risk of kidney failure in individuals with type 2 diabetes. We postulate that finerenone will demonstrate benefits on kidney outcomes in people with type 1 diabetes. METHODS: FINE-ONE (NCT05901831) is a randomised, placebo-controlled, double-blind phase III trial of 7.5 months\u27 duration in ∼220 adults with type 1 diabetes, urine albumin/creatinine ratio (UACR) of ≥ 200-\u3c 5000 mg/g (≥ 22.6-\u3c 565 mg/mmol) and eGFR of ≥ 25-\u3c 90 ml/min/1.73 m RESULTS: The primary endpoint is relative change in UACR from baseline over 6 months. UACR is used as a bridging biomarker (BB), since the treatment effect of finerenone on UACR was associated with its efficacy on kidney outcomes in the type 2 diabetes trials. Based on regulatory authority feedback, UACR can be used as a BB for kidney outcomes to support registration of finerenone in type 1 diabetes, provided necessary criteria are met. Secondary outcomes include incidences of treatment-emergent adverse events, treatment-emergent serious adverse events and hyperkalaemia. CONCLUSIONS: FINE-ONE will evaluate the efficacy and safety of finerenone in type 1 diabetes and CKD. Finerenone could become the first registered treatment for CKD associated with type 1 diabetes in almost 30 years. TRIAL REGISTRATION: ClinicalTrials.gov NCT05901831

Immunomodulatory activity of humanized anti-IL-7R monoclonal antibody RN168 in subjects with type 1 diabetes

BACKGROUND: The cytokine IL-7 is critical for T cell development and function. We performed a Phase Ib study in patients with type 1 diabetes (T1D) to evaluate how blockade of IL-7 would affect immune cells and relevant clinical responses. METHODS: Thirty-seven subjects with T1D received s.c. RN168, a monoclonal antibody that blocks the IL -7 receptor α (IL7Rα) in a dose-escalating study. RESULTS: Between 90% and 100% IL-7R occupancy and near-complete inhibition of pSTAT5 was observed at doses of RN168 1 mg/kg every other week (Q2wk) and greater. There was a significant decline in CD4+ and CD8+ effector and central memory T cells and CD4+ naive cells, but there were fewer effects on CD8+ naive T cells. The ratios of Tregs to CD4+ or CD8+ effector and central memory T cells versus baseline were increased. RNA sequencing analysis showed downmodulation of genes associated with activation, survival, and differentiation of T cells. Expression of the antiapoptotic protein Bcl-2 was reduced. The majority of treatment-emergent adverse events (TEAEs) were mild and not treatment related. Four subjects became anti-EBV IgG+ after RN168, and 2 had symptoms of active infection. The immunologic response to tetanus toxoid was preserved at doses of 1 and 3 mg/kg Q2wk but reduced at higher doses. CONCLUSIONS: This trial shows that, at dosages of 1-3 mg/kg, RN168 selectively inhibits the survival and activity of memory T cells while preserving naive T cells and Tregs. These immunologic effects may serve to eliminate pathologic T cells in autoimmune diseases. TRIAL REGISTRATION: NCT02038764. FUNDING: Pfizer Inc

Landowner willingness to engage in long-term timber leases in West Virginia, USA

As global competition increases for wood-based products, the need for more efficient supply chains becomes increasingly important. In the forest products sector, these supply chains involve individuals and firms ranging from private forestland owners with standing timber to factories producing final finished products. Under the assumption that ‘transparent’ supply chains are beneficial to members within the supply chain, the authors are investigating how this transparency can be increased and what benefits might accrue to private forest owners who are associated with a specific supply chain under a long-term agreement. In recent years, hunting lease agreements between family forest owners and various organized hunt clubs or individuals have become commonplace in the Appalachian mountains of West Virginia. Can long-term timber leases become a new opportunity for landowners, forestry professionals, and wood-based industries? This paper describes a survey of private forestland owners in West Virginia that investigated the perceived concerns, benefits and barriers landowners have with regard to entering long-term timber leases with forestry professionals and timber firms

Comparative effectiveness of sodium-glucose cotransporter 2 inhibitors vs sulfonylureas in patients with type 2 diabetes

IMPORTANCE: In the treatment of type 2 diabetes, evidence of the comparative effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors vs sulfonylureas-the second most widely used antihyperglycemic class after metformin-is lacking. OBJECTIVE: To evaluate the comparative effectiveness of SGLT2 inhibitors and sulfonylureas associated with the risk of all-cause mortality among patients with type 2 diabetes using metformin. DESIGN, SETTING, AND PARTICIPANTS: A cohort study used data from the US Department of Veterans Affairs compared the use of SGLT2 inhibitors vs sulfonylureas in individuals receiving metformin for treatment of type 2 diabetes. A total of 23 870 individuals with new use of SGLT2 inhibitors and 104 423 individuals with new use of sulfonylureas were enrolled between October 1, 2016, and February 29, 2020, and followed up until January 31, 2021. EXPOSURES: New use of SGLT2 inhibitors or sulfonylureas. MAIN OUTCOMES AND MEASURES: This study examined the outcome of all-cause mortality. Predefined variables and covariates identified by a high-dimensional variable selection algorithm were used to build propensity scores. The overlap weighting method based on the propensity scores was used to estimate the intention-to-treat effect sizes of SGLT2 inhibitor compared with sulfonylurea therapy. The inverse probability of the treatment adherence weighting method was used to estimate the per-protocol effect sizes. RESULTS: Among the 128 293 participants (mean [SD] age, 64.60 [9.84] years; 122 096 [95.17%] men), 23 870 received an SGLT2 inhibitor and 104 423 received a sulfonylurea. Compared with sulfonylureas, SGLT2 inhibitors were associated with reduced risk of all-cause mortality (hazard ratio [HR], 0.81; 95% CI, 0.75-0.87), yielding an event rate difference of -5.15 (95% CI, -7.16 to -3.02) deaths per 1000 person-years. Compared with sulfonylureas, SGLT2 inhibitors were associated with a reduced risk of death, regardless of cardiovascular disease status, in several categories of estimated glomerular filtration rate (including rates from \u3e90 to ≤30 mL/min/1.73 m2) and in participants with no albuminuria (albumin to creatinine ratio [ACR] ≤30 mg/g), microalbuminuria (ACR \u3e30 to ≤300 mg/g), and macroalbuminuria (ACR \u3e300 mg/g). In per-protocol analyses, continued use of SGLT2 inhibitors was associated with a reduced risk of death compared with continued use of sulfonylureas (HR, 0.66; 95% CI, 0.60-0.74; event rate difference, -10.10; 95% CI, -12.97 to -7.24 deaths per 1000 person-years). In additional per-protocol analyses, continued use of SGLT2 inhibitors with metformin was associated with a reduced risk of death compared with SGLT2 inhibitor treatment without metformin (HR, 0.70; 95% CI, 0.50-0.97; event rate difference, -7.62; 95% CI, -17.12 to -0.48 deaths per 1000 person-years). CONCLUSIONS AND RELEVANCE: In this comparative effectiveness study analyzing data from the US Department of Veterans Affairs, among patients with type 2 diabetes receiving metformin therapy, SGLT2 inhibitor treatment was associated with a reduced risk of all-cause mortality compared with sulfonylureas. The results provide data from a real-world setting that might help guide the choice of antihyperglycemic therapy

Clinical implications of estimated glomerular filtration rate dip following sodium-glucose cotransporter-2 inhibitor initiation on cardiovascular and kidney outcomes

Background The frequency of the initial short-term decline in estimated glomerular filtration rate (eGFR), eGFR dip, following initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and its clinical implications in real-world practice are not clear. Methods and Results We built a cohort of 36 638 new users of SGLT2i and 209 025 new users of other antihyperglycemics. Inverse probability weighting was used to estimate the excess rate of eGFR dip, risk of the composite cardiovascular outcome of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, or all-cause mortality, and risk of the composite kidney outcome of eGFR decline \u3e50%, end-stage kidney disease, or all-cause mortality. In the first 6 months of therapy, compared with other antihyperglycemics, excess rates of eGFR dip \u3e10% and eGFR dip \u3e30% were 9.86 (95% CI: 8.83-11.00) and 1.15 (0.70-1.62) per 100 SGLT2i users, respectively. In mediation analyses that accounted for eGFR dipping, SGLT2i use was associated with reduced risk of cardiovascular and kidney outcomes (hazard ratio, 0.92 [0.84-0.99] and 0.78 [0.71-0.87], respectively); the magnitude of the association reduced by eGFR dipping was small for both outcomes. SGLT2i was associated with reduced risk of both outcomes in those with higher than average probability of eGFR dip \u3e10% or 30%. Compared with discontinuation, continued use of SGLT2i at 6 months was associated with reduced risk of cardiovascular and kidney outcomes in those with no eGFR dip or eGFR dip ≤10%, in those with eGFR dip \u3e10%, and in those with eGFR dip \u3e30%. Conclusions The salutary association of SGLT2i with cardiovascular and kidney outcomes was maintained regardless of eGFR dipping; concerns about eGFR dipping should not preclude use, and occurrence of eGFR dip after SGLT2i initiation may not warrant discontinuation

Multicenter, randomized trial of a bionic pancreas in type 1 diabetes

BACKGROUND: Currently available semiautomated insulin-delivery systems require individualized insulin regimens for the initialization of therapy and meal doses based on carbohydrate counting for routine operation. In contrast, the bionic pancreas is initialized only on the basis of body weight, makes all dose decisions and delivers insulin autonomously, and uses meal announcements without carbohydrate counting. METHODS: In this 13-week, multicenter, randomized trial, we randomly assigned in a 2:1 ratio persons at least 6 years of age with type 1 diabetes either to receive bionic pancreas treatment with insulin aspart or insulin lispro or to receive standard care (defined as any insulin-delivery method with unblinded, real-time continuous glucose monitoring). The primary outcome was the glycated hemoglobin level at 13 weeks. The key secondary outcome was the percentage of time that the glucose level as assessed by continuous glucose monitoring was below 54 mg per deciliter; the prespecified noninferiority limit for this outcome was 1 percentage point. Safety was also assessed. RESULTS: A total of 219 participants 6 to 79 years of age were assigned to the bionic-pancreas group, and 107 to the standard-care group. The glycated hemoglobin level decreased from 7.9% to 7.3% in the bionic-pancreas group and did not change (was at 7.7% at both time points) in the standard-care group (mean adjusted difference at 13 weeks, -0.5 percentage points; 95% confidence interval [CI], -0.6 to -0.3; P\u3c0.001). The percentage of time that the glucose level as assessed by continuous glucose monitoring was below 54 mg per deciliter did not differ significantly between the two groups (13-week adjusted difference, 0.0 percentage points; 95% CI, -0.1 to 0.04; P\u3c0.001 for noninferiority). The rate of severe hypoglycemia was 17.7 events per 100 participant-years in the bionic-pancreas group and 10.8 events per 100 participant-years in the standard-care group (P = 0.39). No episodes of diabetic ketoacidosis occurred in either group. CONCLUSIONS: In this 13-week, randomized trial involving adults and children with type 1 diabetes, use of a bionic pancreas was associated with a greater reduction than standard care in the glycated hemoglobin level. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; ClinicalTrials.gov number, NCT04200313.)

Environmental Impacts of China Outward Foreign Direct Investment: Case Studies in Latin America, Mongolia, Myanmar, and Zambia

China’s rapid increase of outward foreign direct investment (OFDI) over the past decade has garnered worldwide attention for a variety of reasons. Of particular concern is the concentration of Chinese OFDI in extractive industries, especially in developing countries. Generally, developing countries have fewer and weaker regulations than developed nations, exposing them to more severe environmental degradation. As the environmental consequences of such growth and investment become more visible, governments, companies, and communities pursue better environmental management and protection policies. Increasing environmental awareness and protection measures are evident in China’s 11th and 12th five-year plans, which suggests that domestically China is pursuing a more efficient and sustainable growth than in previous decades. China plans to implement policies to increase accountability and capacity to improve environmental protection. While challenges still exist, namely China’s growing demands for energy, such policies will provide a framework to advance environmental protection. China’s growing demand for and consumption of energy drives Chinese OFDI. The concentration of China’s investment in extractive industries leads to substantial environmental degradation. The majority of investment takes place through large state-owned enterprises. Despite improving its domestic environmental policies, China lacks any environmental regulation of OFDI. Though it promotes corporate social responsibility (CSR) and recently released legal guidelines for OFDI, such practices rely on the initiative of the investing company. The domestic policy environment interacts with the regulations of the recipient countries, resulting in differing environmental impacts. 3 An examination of several countries from varying regions illustrates how investments interact with recipient countries’ regulations. The increase of Chinese investment has affected the environment of South America, Mongolia, Myanmar and Zambia. Chinese investment in South America has allowed China to secure natural resources by increasing petroleum and mining production. Investment has impacted both small and established producers throughout the continent. South America, in particular Peru, shows how political development and improved financial markets can improve the regulatory environment, allowing FDI to benefit recipient countries. Most Chinese FDI entering Mongolia is in the mining sector to meet China’s growing demand for minerals. Investors in this sector include large Chinese state-owned mining enterprises that dominate Mongolia’s largest deposits, as well as small and medium Chinese mining firms in the artisanal mining industry. Unlike their larger counterparts, these small and medium mining firms do not employ environmentally friendly technology to extract minerals. Hence, Chinese artisanal mining has harmed Mongolia’s environment by generating excess surface water, waste rock piles, tailings, and mercury pollution, which causes air and water pollution. Inadequate law enforcement and local government corruption, coupled with the increasing influence of China, have made it difficult for Mongolia’s central government to address these environmental issues. In Myanmar, FDI in the nation’s hydropower, oil and gas and mining sectors has resulted in water pollution, destruction of fisheries, loss of biodiversity and deforestation. Chinese investors and firms from other countries, whose investments predate those of China, caused these environmental issues. They can also be attributed to Naypyitaw’s ineffective environmental governance, resulting from underdeveloped institutions and flouting the of its own environmental 4 laws. To improve environmental governance, Myanmar’s government must develop its institutions, devote more resources to environmental protection and promote environmental education. In Zambia, Chinese investments are concentrated heavily in the country’s copper mining industry. In Zambia, the country’s reliance on the mining sector results in air and water pollution of the surrounding areas. Though Chinese companies are by no means the largest investors or polluters in Zambia’s mining sector, the rapid increase of investments has made China particularly influential. The legislative and regulatory framework exists for environmental protection in Zambia, but the country lacks capacity for enforcement and accountability mechanisms. As such, several international mining companies have no incentive to comply with environmental regulations, worsening environmental degradation. To generate recommendations for improved environmental performance through sustainable outward foreign direct investment, we analyzed several viewpoints. Using the country report, we identified existing regulations and discovered areas where regulations or environmental awareness is lacking. One major observation from the country report is that China does not impose environmental regulations on outward foreign direct investment; instead, the government expects firms to comply with the regulations of the host countries. This raises an interesting question about whether home countries have an incentive to regulate environmentally sensitive areas. We surveyed theory and the existing literature on the pollution haven hypothesis to see if host countries avoid environmental regulations to encourage investment. Although the theory remains popular, robust evidence of the hypothesis does not exist. After completing the theoretical approach, we chose to apply country case studies to see if any developed countries have taken the lead in imposing environmental regulations. After 5 studying the U.S., Canada, and Europe, we found that environmental regulations for in-country development are common. However, like China, these countries do not actively regulate OFDI. In the absence of a global regulatory environment, a collaborative effort is needed. Through the research, we discovered a multi-tiered relationship, in which the home government, the host government, NGOs, and investors can all coordinate to improve environmental outcomes. After noting that the two-way tie between governments and investors is not always sufficient for regulations, we looked into alternative third parties that can affect environmental awareness. Through a literature review, we identified NGOs as powerful actors that can affect information availability, policy, operations, assessment and monitoring, and environmental advocacy. The combination of country analysis, theoretical framework building, case studies, and player identification allows us to formulate recommendations from the macro to the micro level. Specifically, we identified several broad categories where improvements can occur: with local communities and NGOs, with regulatory bodies, and with investors. Some recommendations apply to China’s environmental regulations; some apply to our four country regions; and others apply to investors and NGOs. TNC can help local communities and NGOs develop institutions, increase awareness, and build capacity to enhance management of environmental resources. By partnering with regulatory bodies, TNC can work to improve monitoring of environmental regulations through additional training and providing access to accurate information. Where investors are concerned, TNC and government actors can help improve banking practices and provide incentives to encourage environmental protection.Nature Conservanc